Using a 24-Hour Movement Framework to Improve Pregnancy Outcomes

PROJECT SUMMARY/ABSTRACT
Maternal obesity, gestational diabetes, and childhood obesity are part of a vicious cycle. Almost half of all
reproductive-aged women in the United States are overweight or obese. Overweight and obese women are up
to 6 times more likely to develop GDM than normal weight women. Children exposed to GDM in utero have an
8-fold greater type 2 diabetes risk and a 2-fold greater obesity risk, perpetuating the cycle. Increasing physical
activity and sleep during pregnancy may help mitigate these risks. These behaviors are interrelated: improving
one (e.g. getting more physical activity) could occur at the expense of another (e.g. getting enough sleep). The
ideal daily pattern of physical activity and sleep to prevent pregnancy complications and subsequent childhood
obesity risk factors is unknown. Despite the interrelated nature of these behaviors, prior research on physical
activity, sedentary behavior, and sleep during pregnancy in overweight and obese pregnanct women has
focused on individual associations of these behaviors with perinatal outcomes. How the interdependent
relationships between physical activity, sedentary behavior, and sleep within a 24-hour movement framework
affect perinatal outcomes remains unclear. The goal of this K99/R00 Pathway to Independence Award is to
facilitate my transition to becoming an independent researcher with expertise in the 24-hour movement
framework during pregnancy to ultimately develop interventions and guidelines for 24-hour movement during
this critical period. During the Mentored (K99) Phase of this award, I will pursue training in the analysis of
accelerometer-measured physical activity data, the physiology and measurement of sleep, and practical skills
in research study conduct, including recruitment and retention, under the mentorship of Dr. Monique
Hedderson (Primary Mentor), Dr. Kelley Pettee Gabriel (Co-Mentor and expert in accelerometer-measured
physical activity within a 24-hour movement framework), and Dr. Rachel Manber (Co-Mentor and expert in
sleep during pregnancy). My research during the Mentored Phase will 1) assess whether 24-hour movement
profiles during early pregnancy are associated with late pregnancy maternal metabolic biomarkers, and 2)
assess whether 24-hour movement profiles during early and late pregnancy are associated with delivering
infants with childhood obesity risk factors using data from an existing study among overweight and obese
pregnant women. In the Independent (R00) Phase of this award, I will examine longitudinal relationships of 24-
hour movement profiles during pregnancy with glucose tolerance, birthweight, and neonatal adiposity by
creating a cohort of overweight and obese pregnant women with daily, device-based measurement of physical
activity, sedentary behavior, and sleep across pregnancy. These training and research activities will prepare
me to successfully compete for R01 funding to support further investigation of 24-hour movement profiles and
pregnancy outcomes in high-risk populations of pregnant women.

Grant Number: 5R00HD100585-05
NIH Institute/Center: NIH
Principal Investigator: Sylvia Badon